Tools and methods for biomedical surgery

ABSTRACT

A tool for biomedical surgery comprises an elongate tube-like structure which is insertable into a body lumen, a surgical tool, arranged on the elongate tube-like structure, and a layered polymer microactuator, arranged in or on the elongate tube-like structure, for inducing geometrical changes or movements to the surgical tool via an electrochemically induced change of volume of the layered polymer microactuator. The layered polymer microactuator is arranged for external electrical actuation.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a continuation-in-part of U.S. applicationSer. No. 10/018,985, filed Dec. 19, 2001.

TECHNICAL FIELD

This invention concerns micro-surgical tools that can be delivered by oron an elongated medical device, such as a catheter or needle. Thesetools or microstructures can be used to adapt, assemble, separate,fortify, dilate, close and hold biological or non-biological structuresinside the body during and after surgery. The tools may be stents,valves, clips, nets, knives, scissors, dilators, clamps, tweezers etc.

BACKGROUND

The use of microstructures to assemble, fortify or dilate biologicalstructures inside the body during and after surgery can help the surgeonin a number of ways. The operation of electrically actuated tools canhelp the surgeon to simultaneously position, operate manually, andobserve. By positioning the tool by hand and separately operating thetool through external control (i.e. footswitch, voice control, othersoftware-control) a much higher degree of precision is achieved. Inmicrosurgery, this is especially desired.

The development of microactuators has been spurred by the desire to beable to use tools before or during invasive surgical procedures. Becausetools may be used for cutting, drilling, holding, dilating, suturing,adapting or supporting, the tools must have specific size and shape. Forexample, a certain tool might be needed during a surgery and may beintroduced through, placed inside, on, or located at the end of acatheter or needle. Thus, the tool must be designed within the specificdimension of the catheter or needle.

The application of structures in/on or introduced through a catheter orneedle is of particular interest in connection with the application oftools, which are to be left at the site after insertion, and which haveto execute their function for some limited time duration after, andwhich may thereafter be extracted.

The combination of microactuators and catheters is not well documentedin the literature. No patents describe the use of microactuators astools housed inside or on a catheter. However, some examples ofmicroactuators used to position a catheter have been found.

U.S. Pat. No. 5,771,902 and U.S. Pat. No. 5,819,749 disclosemicromachined actuators and sensors for intratubular positioning andsteering of for instance catheters in blood flows. The microcantileveractuators, that may comprise conducting polymers, are used as rudders orvalves in order to provide navigation means for catheters and the likethat utilize the blood flow direction for positioning or steering.

WO9837816A1 discloses microfabricated therapeutic actuators that arefabricated using shape memory polymers. The actuators are used as amicrotubing release mechanism to set free an object.

WO9739688A2 describes a method and apparatus for delivery of a clipappliance in a vessel. The clip is configured from a wire like bendablematerial, preferably #420 stainless steel, having a W-like sinusoidalshape. Upon delivery the clip is bent so as to be secured to tissue byan external biasing apparatus, such as an actuator arm and balloon.

The publication WO9739674A1 discloses a spring based multi-purposemedical instrument. Spring jaws at the distal end are operated through aremote actuator. The preferred embodiment of this jaw actuator is a verythin (pull) wire.

U.S. Pat. No. 5,855,565 describes a cardiovascular mechanicallyexpanding catheter apparatus as an alternative to conventional balloonangioplasty devices. The catheter comprises a dilation means thatincludes a mechanical expander which provides means for casing radialexpansion of the dilation means against the vessel walls uponlongitudinal contraction of the mechanical expander. The longitudinalcontraction of the mechanical expander may preferably be achieved by acable mechanism, however the use of an “artificial muscle” as thecontraction means is also claimed.

There is a need for improved or alternative tools that may be introducedthrough or on a catheter or needle and used before, during or aftersurgical procedures.

SUMMARY OF THE INVENTION

It is an object of the present disclosure to provide tools that overcomeor alleviate disadvantages of prior art tools.

According to a first aspect, there is provided a device for biomedicalsurgery, comprising an elongate tube-like structure which is insertableinto a body lumen, a surgical tool, arranged on the elongate tube-likestructure, and a layered polymer microactuator, arranged in or on theelongate tube-like structure, for inducing geometrical changes ormovements to the surgical tool via an electrochemically induced changeof volume of the polymer microactuator, the layered polymermicroactuator being arranged for external electrical actuation.

In an embodiment, a guide-wire may be insertable into the elongatetube-like structure.

In an embodiment, the layered polymer microactuator may comprise abi-layered polymer.

In an embodiment, the layered polymer microactuator may comprise atleast one non-polymer layer.

In an embodiment, the layered polymer microactuator may comprise aconjugated polymer layer.

In an embodiment, the conjugated polymer layer may comprise a polymerselected from the group consisting of pyrrole, aniline, thiophene,para-phenylene, vinylene, and phenylene polymers and copolymers,including substituted forms of the different monomers.

In an embodiment, the layered polymer microactuator may comprise atleast two layers, where an electrically activated volume change of saidat least one conjugated polymer layer is arranged to cause a bending ofsaid layered polymer actuator.

In an embodiment, the surgical tool may be selected from a groupconsisting of a knife, a needle, a dilator, a forceps, a scissors, atweezers, a clamp, a clip, a stent, a connector, a graft, a nerveconnector, and an insertion device.

In an embodiment, the surgical tool may be an insertion device formaking a temporary permanent hole through a membrane, the insertiondevice comprising a central member and a number of anchoring members,which are bendable between an insertion position, wherein the insertiondevice is insertable through a hole in the membrane, and an anchoringposition, wherein the anchoring members are in fixating engagement withthe membrane.

In an embodiment, the surgical tool may be releasable from the tube-likestructure.

According to a second aspect, there is provided a tool array comprisinga device according to the first aspect, wherein a number of identicalsurgical tools are arranged as an array extending on the carrier ortube-like structure, and wherein the actuation of a surgical toolclosest to the exit of the tube-like structure is arranged to releasethe surgical tool from the array and to leave it at the point of exit ofthe tube-like structure in order to mount the surgical tool at or in abiological structure.

In an embodiment, a number of identical tools may be located on thearray extending along the tube-like structure, and where each tool isindividually actuatable.

In an embodiment, a number of identical tools may be located on thearray extending along the tube-like structure, and said tools aresimultaneously actuatable.

According to a third aspect, there is provided a tool array comprising atool according to the first aspect, wherein a number of non-identicalsurgical tools are arranged as an array extending along a length of thecarrier or tube-like structure, and wherein said tools are individuallyactuatable, and wherein the actuation of a surgical tool closest to theexit of the tube-like structure is arranged to release the surgical toolfrom the array and to leave it at the point of exit of the tube-likestructure in order to mount the surgical tool at or in a biologicalstructure.

According to a fourth aspect, there is provided a device for biomedicalsurgery, comprising an elongate tube-like structure, which is insertableinto a body lumen, a carrier which is insertable into the elongatetube-like structure, a surgical tool, arranged on the carrier, and apolymer microactuator, arranged in or on the carrier, for inducinggeometrical changes or movements to the surgical tool via anelectrochemically induced change of volume of the polymer microactuator,the polymer microactuator being arranged for external electricalactuation.

In an embodiment, the polymer microactuator may comprise a conjugatedpolymer.

In an embodiment, the conjugated polymer may comprise a polymer selectedfrom the group consisting of pyrrole, aniline, thiophene,para-phenylene, vinylene, and phenylene polymers and copolymers,including substituted forms of the different monomers.

In an embodiment, the polymer microactuator may be a layered polymermicroactuator.

In an embodiment, the polymer microactuator may comprise at least twolayers, where an electrically activated volume change of said at leastone conjugated polymer layer is arranged to cause a bending of saidlayered polymer actuator.

In an embodiment, the surgical tool may be selected from a groupconsisting of a knife, a needle, a dilator, a forceps, a scissors, atweezers, a clamp, a clip, a stent, a connector, a graft, a nerveconnector, and an insertion device.

In an embodiment, the surgical tool may be an insertion device formaking a temporary permanent hole through a membrane, the insertiondevice comprising a central member and a number of anchoring members,which are bendable between an insertion position, wherein the insertiondevice is insertable through a hole in the membrane, and an anchoringposition, wherein the anchoring members are in fixating engagement withthe membrane.

In an embodiment, the surgical tool may be releasable from the tube-likestructure.

According to a fifth aspect, there is provided a tool array comprising adevice according to the fourth aspect, wherein a number of identicalsurgical tools are arranged as an array extending on the carrier ortube-like structure, and wherein the actuation of a surgical toolclosest to the exit of the tube-like structure is arranged to releasethe surgical tool from the array and is to leave it at the point of exitof the tube-like structure in order to mount the surgical tool at or ina biological structure.

In an embodiment, a number of identical tools may be located on thearray extending along the tube-like structure, and where said tools areindividually actuatable.

In an embodiment, a number of identical tools may be located on thearray extending along the tube-like structure, and where said tools aresimultaneously actuatable.

According to a sixth aspect, there is provided a tool array comprising atool according to the fourth aspect, wherein a number of non-identicalsurgical tools are arranged as an array extending along a length of thecarrier or tube-like structure, and wherein said tools are individuallyactuatable, and wherein the actuation of a surgical tool closest to theexit of the tube-like structure is arranged to release the surgical toolfrom the array and to leave it at the point of exit of the tube-likestructure in order to mount the surgical tool at or in a biologicalstructure.

According to a seventh aspect, there is provided a method of biomedicalsurgery, comprising steps of:

inserting an elongate tube-like structure comprising a surgical toolarranged thereon, into a body lumen;

the elongate tube-like structure having a layered polymer microactuator,arranged in or on the elongate tube-like structure, for inducinggeometrical changes or movements to the surgical tool via anelectrochemically induced change of volume of the polymer microactuator;

and supplying an electrical charge for electrical actuation of thepolymer microactuator,

whereby said geometrical changes or movements cause the tool to act upona biological structure in said body lumen.

In the above method, said geometrical changes or movements may cause thesurgical tool to perform an activity selected from a group consisting ofpositioning a stucture, holding a structure, cutting a structure,dilating a structure, fortifying a structure and implanting a structure.

According to an eighth aspect, there is provided a method of biomedicalsurgery, comprising steps of:

inserting an elongate tube-like structure into a body lumen;

inserting a carrier with a surgical tool arranged thereon, into saidtube-like structure,

the carrier having a polymer microactuator, arranged in or on thecarrier, for inducing geometrical changes or movements to the surgicaltool via an electrochemically induced change of volume of the polymermicroactuator; and

supplying an electrical charge for electrical actuation of the polymermicroactuator,

whereby said geometrical changes or movements cause the tool to act upona biological structure in said body lumen.

In the above method, said geometrical changes or movements may cause thesurgical tool to perform an activity selected from a group consisting ofpositioning a stucture, holding a structure, cutting a structure,dilating a structure, fortifying a structure and implanting a structure.

The necessary elements to accomplish these functions may be theelectrochemically activated microactuators, built by micromachining thinmetal and polymer layers (Elisabeth Smela, Olle Inganäs and IngemarLundström: “Controlled Folding of Micron-size Structures”, Science 268(1995) pp. 1735-1738), non-metal and polymer layers, or only polymerlayers. These actuators can be produced in sizes fom micrometers tocentimeters, and operate well in biological fluids such as blood plasma,blood, buffer and urine. They are therefore suitable tools for microinvasive surgery inside the body.

The versatility of construction and the speed of response, as well asthe force of these actuators render them as one of the best types ofmicroactuators inside the body. WO96/28841 discloses one route offabrication of such devices.

BRIEF DESCRIPTION OF THE DRAWINGS

The different aspects of the invention can be better understood withreference to the following drawings. The components in the drawings arenot necessarily to scale, emphasis instead being placed upon clearlyillustrating the principles of the present disclosure. Moreover, in thedrawings, like reference numerals designate corresponding partsthroughout the several views.

FIGS. 1 a-1 c are a perspective view of a first embodiment.

FIGS. 2 a-2 g are a perspective view of other tools in whichmicroactuators are used.

FIGS. 3 a-3 b are a perspective view of another embodiment.

FIGS. 4 a-4 b are perspective views of yet another embodiment.

FIGS. 5 a-5 b are perspective views of a further embodiment.

FIGS. 6 a-c are perspective views of other tools in which microactuatorsare used

DESCRIPTION OF EMBODIMENTS

Our novelty and innovation resides in the use of microactuators based onconjugated polymers being electrically operated and mounted in or on anelongated medical device for insertion into the body, such as a catheteror needle. These microactuators are positioned with the help of thecatheter, and then these microactuator structures that are carried by,in, or on the catheter or needle are activated. The microfabrication ofsuch microactuators renders possible a number of geometries and a sizeas small as 10 μm, which is difficult to produce by mechanicalproduction techniques. They may be produced by use of the methodpresented in patent WO96/28841 and then mounted in or on the needle orcatheter, or they might be produced by novel manufacturing methods. Withthe invention described herein completely novel microsurgery tools arenow available.

The production of individually actuated tool arrays render littledifficulty beyond producing the individual tool. Electrical contacts maybe supplied to actuate each microactuator separately. This can be doneby wiring the single microactuator, to be used as the working electrode;the catheter may then be used as the counter-electrode, and will be ableto supply all the charge that is needed to actuate all thosemicroactuators. As wires may easily be produced in width down to 10 μmwith photolithography or with soft lithography, thus by providingparallel conducting wires, at least 50 microactuators may be placedalong the tool array located in/on a needle of 1 mm width. Should morewires be necessary, more elaborate addressing schemes might be used.

If a three electrode system is necessary in any application,microfabricated reference electrodes or macrosize reference electrodescarried on the catheter housing can be used as a third electrode.

A first embodiment of the present invention is clips and clip arrays,where the clips are mounted in sequence, used for surgery. These clipsare sub-millimetre to millimetre structures, used two hold two separatedbiological or non-biological structures joined, for example during ahealing period. Also a biological and a non-biological structure may beheld together.

FIGS. 1 a-1 c show an example of a clip tool in which microactuators maybe used. Clips may be used in surgery to hold together two separatedbiological structures, such as tissue, skin, membranes, vessel wallsetc; or to fixate a biological structure to a non-biological structure.

FIG. 1 a shows a clip 1 that is individually activated by amicroactuator in its opened stated and a structure 2, which isinterconnected as shown in FIGS. 1 a-1 b or having to separated parts.In FIG. 1 b, the clip 1 is in its closed state and is used to join thestructure 2 to hold it closed.

As shown in FIG. 1 c the clips may be assembled into clip arrays, wherethe clips 1, 4 are mounted in sequence 5, and are confined by acylindrical housing 3. The clip 1 is attached to a second clip 4, whichin its turn is attached to a third clip 6, etc thus building a chain ofclips 5 that are confined by the cylindrical housing 3. The cylindricalhousing 3 may be a catheter or a hollow needle. Activation of theoutermost clip 1 opens up the clip 1 to join the open structure 2, andthen being set free by the simultaneous or sequential operation of thesecond clip 4. The clip 1 is left at the structure 2, holding thestructures together as illustrated in FIGS. 1 a-1 b.

Another embodiment is a structure for controlling the flow through bloodvessels. The simplest example is that of a clip used to prevent orregulate the amount of blood flow to a biological structure downstreamin the blood vessel. Such a clip, or series of clips, would be mountedand left to hold a firm grip on the blood vessel and thus to prevent orregulate the flow of blood.

An array of tools may be collectively addressed, and the tool array maybe designed to set free the outermost clip 1 on actuation of all theclips 5, a mechanism of confining the movements of all but the outermostclip 1 is needed. This is done by assembling the clip array 5 into acylindrical housing 3, preferably a catheter, prior to insertion in thebody. The cylindrical housing 3 confines the motion of microactuators,which search in vain to expand the strong metal casing on operation.When the outermost clip 1 is actuated, the clip is opened; likewise isthe next-to-the outermost clip 4 partially free to move as it isprotruding outside the cylindrical housing 3. Therefore the partialopening of the next-to-the outermost clip 4 sets the outermost clip 1free, as well as opens it up for subsequent spontaneous closing on thesite to be clipped.

The array of clips 5 may be pushed forward, out of the cyclindricalhousing 3 by a wire, rod, or plunger (as illustrated by part 370 inFIGS. 4 a-4 b) thus releasing one clip at the time.

FIGS. 2 a-2 g shows tubular tweezers 100, tweezers 110 knifes 120,scissors 122, needles 124, dilators 126, and clamps 128 based onmicroactuators. The indicated movement is driven by microactuatorsproperly mounted and designed. The tools are housed in a cyclindricalhousing 140, which for example may be a needle or a catheter. Thesetools or micro-structures can be used to adapt, assemble, separate,fortify, dilate, close and hold biological structures inside the bodyduring and after surgery.

FIGS. 3 a-3 b show a another embodiment 230 of the present invention.Arrays of fingers could be used to hold cylindrical objects, such asnerves and nerve fibers, or blood vessels. With the help ofmicroactuators holding the structures (FIGS. 3 a-3 b), adjacentmicrostructures may operate, such as neural sensing or activatingelectrodes, may enable recording signals from or activating nerves.Furthermore, they could be used as a synthetic neural connectors,bridging a severed nerve or nerve fiber. A neural connector 230, with anumber of small fingers 220 coil around two cylindrical nerves 200, 210to tightly hold the nerve 240 together. Two separate nerves 200, 210 arehere joined with the help of a common neural connector 230. Thisprocedure is used to regrow the nerves. In addition, small electrodes(not shown) can be fashioned along with the microfingers 220, and beused to sense or excite nerve signals.

Tools with some temporary mechanical function could also be inserted inmembranes (FIGS. 4 a-4 b) or inserted or anchored into any type oftissue. Insertion devices with temporary mechanical functions could beused for mounting a hole through a membrane, such as commonly used inear surgery for pressure equilibration. Making these as microdeviceswill much decrease the effort to place and remove the inserted devicesand to keep them in place during the desired time period. FIGS. 4 a-4 bshow a further embodiment 300 of the present invention. An insertiondevice 330, for making a temporally hole in a membrane 330 is housed ina catheter/cannula/needle 310 and is inserted through the membrane 320so as to make the device 330 form a hole 350 through the membrane. Thedevice 330 may be pushed forward, out of the catheter/cannula/needle 310by a wire, rod or plunger 370, thus releasing it into the membrane 320.Simultanously or sequentially on insertion into the membran 320 flaps orpetals 360 may fold out in order to anchor the device 330 into themembrane.

FIGS. 5 a-5 a show a stent device 400. This embodiment is somewhat morecomplex with structures built with a geometry where they could be usedinside or outside tube-like structures 410, as so called stents 420 todilate a stenotic area 430 or to internally or externally fortify orjoin the structure(s) (FIGS. 5 a and 5 b). Stents 420 are of particularinterest since they are to be inserted inside the tube 410, then to beleft there to expand a stenotic (examples: blood vessel, biliary duct)or to fortify a weak (examples: blood vessel with aneurysm, dividedbiliary duct) part of a tubular structure 410. In the latter case thestructures 420 are preferably addressed as microanastomosis devices ofgrafts.

Likewise the clip arrays (FIG. 1 c) the stent device 400 (FIGS. 5 a-5 b)may be formed/designed as a tool array comprising several stents,microanastomis devices, or grafts, that can be set free one at a time.Also, similar to the medical device of FIGS. 4 a-4 b, the stent 420 orarray of stents may be pushed forward, out of the cyclindrical housing440 by a wire, rod, or plunger (as illustrated by part 370 in FIGS. 4a-4 b), thus releasing one stent at the time.

FIGS. 6 a-6 c illustrate tools or tool arrays that are mounted on anelongated medical device 540 such as a catheter. The elongated medicaldevices comprising the tool or tool arrays are introduced into the bodyby sliding it over a guidewire 510 as is known to those skilled in theart. Examples of such tools or tool arrays are tubular tweezers 500(FIG. 6 a), knives 520 (FIG. 6 b), or stents 550 (FIG. 6 c). FIG. 6 cshows only one stent 550 on the device 540, however, as mentioned aboveand illustrated in FIG. 1 c, the device may comprise several such tools(stents, clips, grafts, coils) forming a tool array.

The application of structures in/on or introduced through a catheter orneedle is of particular interest at the application of tools, which areto be left at the site after insertion, and which have to execute theirfunction for some limited time duration after. Such structures mayoptionally be removed or replaced after such limited time.

Clips, stents, finger arrays and insertion devices, once applied, couldthus be resorbable or permanent. They could express various degrees ofstimulation or repression of cell growth on its surfaces, variousdegrees of anti-thrombotic activity as well as different antibioticactivities. They can also be carriers of various biochemical orbiological components.

It should be emphasized that the above-described embomdiments of thepresent invention are merely possible examples of implementations,merely set forth for clear understanding fo the priniciples of theinvention. Many variations and modifications may be made to theabove-described embodiment(s) of the invention without departingsubstantially from the spirit and principles of the invention. All suchmodifications and variantions are intended to be included herein withinthe scope of this disclosure and the present invention and protected bythe following claims.

In summary, according to a first variant, there is provided a device forbiomedical surgery, comprising an elongate tube-like structure which isinsertable into a body lumen, a surgical tool, arranged on the elongatetube-like structure, and a layered polymer microactuator, arranged in oron the elongate tube-like structure, for inducing geometrical changes ormovements to the surgical tool via an electrochemically induced changeof volume of the polymer microactuator, the layered polymermicroactuator being arranged for external electrical actuation.

According to a second variant, there is provided a device for biomedicalsurgery, comprising an elongate tube-like structure, which is insertableinto a body lumen, a carrier which is insertable into the elongatetube-like structure, a surgical tool, arranged on the carrier, and apolymer microactuator, arranged in or on the carrier, for inducinggeometrical changes or movements to the surgical tool via anelectrochemically induced change of volume of the polymer microactuator,the polymer microactuator being arranged for external electricalactuation.

In the second variant, a conductor may be arranged on the carrier.

In the second variant, the carrier may be elongate.

In the second variant, the carrier may be a needle.

In the second variant, the elongate tube-like structure may be acatheter or a cannula.

In either of the first and second variants, the surgical tool may aknife, a needle, a dilator, a forceps, a scissors, a tweezers, a clamp,a clip, a stent, a connector or a graft.

a guide-wire may be insertable into the elongate tube-like structure.

In either of the first and second variants, the elongate tube-likestructure may be a catheter or cannula.

In either of the first and second variants, the polymer microactuatormay be arranged for external electrical actuation through the elongatetube-like structure.

In either of the first and second variants, the layered polymer maycomprise comprises at least one polymer layer. However, in the secondvariant, this is not necessary.

In either of the first and second variants, the layered polymer maycomprise a bi-layered polymer.

In either of the first and second variants, the layered polymer maycomprise at least one non-polymer layer.

In either of the first and second variants, the layered polymermicroactuator may comprise a conjugated polymer layer.

In either of the first and second variants, the conjugated polymer layermay comprise a polymer is selected from the group consisting of pyrrole,aniline, thiophene, para-phenylene, vinylene, and phenylene polymers andcopolymers, including substituted forms of the different monomers.

In either of the first and second variants, the layered polymermicroactuator may comprise at least two layers, where an electricallyactivated volume change of said at least one conjugated polymer layer isarranged t cause a bending of said layered polymer actuator.

In either of the first and second variants, the device may comprise amultilayered polymer, wherein an electrically activated volume change ofsaid conjugated polymer is arranged to cause a bending of said layeredpolymer microactuator.

In either of the first and second variants, the surgical tool maycomprise a clip arranged to join biological tissues or tissue parts, andarranged to hold the said tissues or tissue parts to allow healing.

In either of the first and second variants, the surgical tool maycomprise a clip arranged to join a biological tissue or tissue part to anon-biological part.

In either of the first and second variants, the surgical tool maycomprise an expandable cylindrical object designed to be inserted, in acontracted state, into a biological tube, and arranged to becomeexpanded to keep said tube in an expanded state or to join two or morebiological tubes.

In either of the first and second variants, the surgical tool maycomprise a knife, which is arranged for linear and/or angular movement.

In either of the first and second variants, the surgical tool maycomprise a needle that is arranged on an actuator being arranged forlinear and/or angular movement.

In either of the first and second variants, the surgical tool maycomprise a nerve connector.

In either of the first and second variants, the surgical tool maycomprise an insertion device for making a temporary permanent holethrough a membrane.

In either of the first and second variants, the insertion device maycomprise a central member and a number of anchoring members, which arebendable between an insertion position, wherein the insertion device isinsertable through a hole in the membrane, and an anchoring position,wherein the anchoring members are in fixating engagement with themembrane.

In either of the first and second variants, the surgical tool may bereleasable from the tube-like structure.

Furthermore, there is provided a tool array comprising a deviceaccording to either of the first and second variants, wherein a numberof identical surgical tools are arranged as an array extending on thecarrier or tube-like structure, and wherein the actuation of a surgicaltool closest to the exit of the tube-like structure is arranged torelease the surgical tool from the array and is to leave it at the pointof exit of the tube-like structure in order to mount the surgical toolat or in a biological structure.

In the array, the surgical tool may be selected from a group consistingof a knife, a needle, a dilator, a forceps, a scissors, a tweezers, aclamp, a clip, a stent, a connector, a nerve connector and a graft.

In the array, the surgical tool may comprise a clip arranged to joinbiological tissues or tissue parts, and arranged to hold the saidtissues or tissue parts to allow healing.

In the array, the surgical tool may comprise an insertion device formaking a temporary permanent hole through a membrane.

In the array, the insertion device may comprise a central member and anumber of anchoring members, which are bendable between an insertionposition, wherein the insertion device is insertable through a hole inthe membrane, and an anchoring position, wherein the anchoring membersare in fixating engagement with the membrane or tissue.

In the array, a number of identical tools may be located on the arrayextending along the tube-like structure, and where each tool isindividually actuatable.

In the array, a number of identical tools may be located on the arrayextending along the tube-like structure, and each tool may besimultaneously actuatable.

In the array, a number of non-identical tools may be arranged as anarray extending along a length of the carrier or tube-like structure,and each tool may be individually actuatable.

Furthermore, there is provided a method of biomedical surgery,comprising steps of inserting an elongate tube-like structure comprisinga surgical tool arranged thereo, into a body lumen; the elongatetube-like structure having a layered polymer microactuator, arranged inor on the elongate tube-like structure, for inducing geometrical changesor movements to the surgical tool via an electrochemically inducedchange of volume of the polymer microactuator; and supplying anelectrical charge for electrical actuation of the polymer microactuator,whereby said geometrical changes or movements cause the tool to act upona biological structure in said body lumen.

In the method, a guide-wire may be inserted into the elongate tube-likestructure.

In the method, a catheter or cannula may be used as the elongatetube-like.

In the method, the polymer microactuator may be externally electricallyactuated through the elongate tube-like structure.

Finally, there is provided a method of biomedical surgery, comprisingsteps of inserting an elongate tube-like structure into a body lumen;inserting a carrier with a surgical tool arranged thereon, into saidtube-like structure, the carrier having a polymer, arranged in or on thecarrier, for inducing geometrical changes or movements to the surgicaltool via an electrochemically induced change of volume of the polymermicroactuator; and supplying an electrical charge for electricalactuation of the polymer microactuator, whereby said geometrical changesor movements cause the tool to act upon a biological structure in saidbody lumen.

In the method, said electrical charge may be supplied through aconductor arranged on the carrier.

In the method, an elongate carrier may be used.

In the method, a needle may be used as a carrier.

In the methods, the elongate tube-like structure may be a catheter or acannula.

In the methods, the geometrical changes or movements may cause thesurgical tool to position a structure.

In the methods, the geometrical changes or movements may cause thesurgical tool to hold a biological or non-biological structure.

In the methods, the geometrical changes or movements may cause thesurgical tool to cut a biological or non-biological structure.

In the methods, the geometrical changes or movements may cause thesurgical tool to dilate a biological or non-biological structure.

In the methods, the geometrical changes or movements may cause thesurgical tool to fortify a biological or non-biological structure.

In the methods, the geometrical changes or movements may cause thesurgical tool to implant a biological or non-biological structure.

In the methods, the geometrical changes or movements cause the surgicaltool to position a structure.

1. A device for biomedical surgery, comprising: an elongate tube-likestructure which is insertable into a body lumen, a surgical tool,arranged on the elongate tube-like structure, and a layered polymermicroactuator, arranged in or on the elongate tube-like structure, forinducing geometrical changes or movements to the surgical tool via anelectrochemically induced change of volume of the polymer microactuator,the layered polymer microactuator being arranged for external electricalactuation.
 2. The device as claimed in claim 1, wherein a guide-wire isinsertable into the elongate tube-like structure.
 3. The device asclaimed in claim 1, wherein the layered polymer microactuator comprisesa bi-layered polymer.
 4. The device as claimed in claim 1, wherein thelayered polymer microactuator comprises at least one non-polymer layer.5. The device as claimed in claim 1, wherein the layered polymermicroactuator comprises a conjugated polymer layer.
 6. The device asclaimed in claim 5, wherein the conjugated polymer layer comprises apolymer selected from the group consisting of pyrrole, aniline,thiophene, para-phenylene, vinylene, and phenylene polymers andcopolymers, including substituted forms of the different monomers. 7.The device as claimed in claim 5, wherein the layered polymermicroactuator comprises at least two layers, where an electricallyactivated volume change of said at least one conjugated polymer layer isarranged to cause a bending of said layered polymer actuator.
 8. Thedevice as claimed in claim 1, wherein the surgical tool is selected froma group consisting of a knife, a needle, a dilator, a forceps, ascissors, a tweezers, a clamp, a clip, a stent, a connector, a graft, anerve connector, and an insertion device.
 9. The device as claimed inclaim 8, wherein the surgical tool is an insertion device for making atemporary permanent hole through a membrane, the insertion devicecomprising a central member and a number of anchoring members, which arebendable between an insertion position, wherein the insertion device isinsertable through a hole in the membrane, and an anchoring position,wherein the anchoring members are in fixating engagement with themembrane.
 10. The device as claimed in claim 1, wherein the surgicaltool is releasable from the tube-like structure.
 11. A tool arraycomprising a device as claimed in claim 1, wherein a number of identicalsurgical tools are arranged as an array extending on the carrier ortube-like structure, and wherein the actuation of a surgical toolclosest to the exit of the tube-like structure is arranged to releasethe surgical tool from the array and to leave it at the point of exit ofthe tube-like structure in order to mount the surgical tool at or in abiological structure.
 12. The tool array as claimed in claim 11, whereina number of identical tools are located on the array extending along thetube-like structure, and where each tool is individually actuatable. 13.The tool array as claimed in claim 11, wherein a number of identicaltools are located on the array extending along the tube-like structure,and said tools are simultaneously actuatable.
 14. A tool arraycomprising a device as claimed in claim 1, wherein a number ofnon-identical surgical tools are arranged as an array extending along alength of the carrier or tube-like structure, and wherein said tools areindividually actuatable, and wherein the actuation of a surgical toolclosest to the exit of the tube-like structure is arranged to releasethe surgical tool from the array and to leave it at the point of exit ofthe tube-like structure in order to mount the surgical tool at or in abiological structure.
 15. A device for biomedical surgery, comprising:an elongate tube-like structure, which is insertable into a body lumen,a carrier which is insertable into the elongate tube-like structure, asurgical tool, arranged on the carrier, and a polymer microactuator,arranged in or on the carrier, for inducing geometrical changes ormovements to the surgical tool via an electrochemically induced changeof volume of the polymer microactuator, the polymer microactuator beingarranged for external electrical actuation.
 16. The device as claimed inclaim 15, wherein the polymer microactuator comprises a conjugatedpolymer.
 17. The device as claimed in claim 16, wherein the conjugatedpolymer comprises a polymer selected from the group consisting ofpyrrole, aniline, thiophene, para-phenylene, vinylene, and phenylenepolymers and copolymers, including substituted forms of the differentmonomers.
 18. The device as claimed in claim 15, wherein the polymermicroactuator is a layered polymer microactuator.
 19. The device asclaimed in claim 18, wherein the polymer microactuator comprises atleast two layers, where an electrically activated volume change of saidat least one conjugated polymer layer is arranged to cause a bending ofsaid layered polymer actuator.
 20. The device as claimed in claim 15,wherein the surgical tool is selected from a group consisting of aknife, a needle, a dilator, a forceps, a scissors, a tweezers, a clamp,a clip, a stent, a connector, a graft, a nerve connector, and aninsertion device.
 21. The device as claimed in claim 20, wherein thesurgical tool is an insertion device for making a temporary permanenthole through a membrane, the insertion device comprising a centralmember and a number of anchoring members, which are bendable between aninsertion position, wherein the insertion device is insertable through ahole in the membrane, and an anchoring position, wherein the anchoringmembers are in fixating engagement with the membrane.
 22. The device asclaimed in claim 15, wherein the surgical tool is releasable from thetube-like structure.
 23. A tool array comprising a device as claimed inclaim 15, wherein a number of identical surgical tools are arranged asan array extending on the carrier or tube-like structure, and whereinthe actuation of a surgical tool closest to the exit of the tube-likestructure is arranged to release the surgical tool from the array and isto leave it at the point of exit of the tube-like structure in order tomount the surgical tool at or in a biological structure.
 24. The toolarray as claimed in claim 23, wherein a number of identical tools arelocated on the array extending along the tube-like structure, and wheresaid tools are individually actuatable.
 25. The tool array as claimed inclaim 23, wherein a number of identical tools are located on the arrayextending along the tube-like structure, and where said tools aresimultaneously actuatable.
 26. A tool array comprising a device asclaimed in claim 15, wherein a number of non-identical surgical toolsare arranged as an array extending along a length of the carrier ortube-like structure, and wherein said tools are individually actuatable,and wherein the actuation of a surgical tool closest to the exit of thetube-like structure is arranged to release the surgical tool from thearray and to leave it at the point of exit of the tube-like structure inorder to mount the surgical tool at or in a biological structure.
 27. Amethod of biomedical surgery, comprising steps of: inserting an elongatetube-like structure comprising a surgical tool arranged thereon, into abody lumen; the elongate tube-like structure having a layered polymermicroactuator, arranged in or on the elongate tube-like structure, forinducing geometrical changes or movements to the surgical tool via anelectrochemically induced change of volume of the polymer microactuator;and supplying an electrical charge for electrical actuation of thepolymer microactuator, whereby said geometrical changes or movementscause the tool to act upon a biological structure in said body lumen.28. The method as claimed in claim 27, wherein said geometrical changesor movements are cause the surgical tool to perform an activity selectedfrom a group consisting of positioning a stucture, holding a structure,cutting a structure, dilating a structure, fortifying a structure andimplanting a structure.
 29. A method of biomedical surgery, comprisingsteps of: inserting an elongate tube-like structure into a body lumen;inserting a carrier with a surgical tool arranged thereon, into saidtube-like structure, the carrier having a polymer microactuator,arranged in or on the carrier, for inducing geometrical changes ormovements to the surgical tool via an electrochemically induced changeof volume of the polymer microactuator; and supplying an electricalcharge for electrical actuation of the polymer microactuator, wherebysaid geometrical changes or movements cause the tool to act upon abiological structure in said body lumen.
 30. The method as claimed inclaim 29, wherein said geometrical changes or movements cause thesurgical tool to perform an activity selected from a group consisting ofpositioning a stucture, holding a structure, cutting a structure,dilating a structure, fortifying a structure and implanting a structure.